OBJECTIVES: This study examined the mechanisms of ventricular tachycardia (VT) and the outcomes of VT ablation in patients using a left ventricular assist device (LVAD) as a temporary treatment for the cardiac transplant. BACKGROUND: An increasingly common complication of continuous-flow LVADs is VT, which is common with end-stage heart failure. METHODS: This study is an analysis of prospective and retrospective data on cardiac transplant candidates undergoing LVAD surgery at Hermann Hospital over five years, 2016- 2023. An electronic review of medical records was performed, including testing, images, and past medical history. The authors confirm that they have adhered to the journal’s ethical guidelines, as specified on the journal’s author guidelines page, and have obtained the necessary approvals from the appropriate ethical review committee. RESULTS: A total of 10 VT accidents were reported among 7 VAD cases. 42 % (3) of the patients had VT within 30 days of VAD implantation, 14 % (1) BBRVT, and 28 % (2) VT from inflow cannula, while 57 % (4) had more than one ablation and 57 % (4) survived one year. LVAD intervention improved the quality of life and survival in over 50% of patients (4/7). CONCLUSIONS: This single-center study of VT ablation in destination LVADs showed that freedom from recurrent VT and implantable defibrillator shocks were associated with improved 1-year survival. Most VTs were monomorphic, cannula adjacent (2/10), and one bundle branch recurrent VT out of ten. Mortality and thrombosis remain a problem for this challenging population.